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Increased carotid intima-media thickness predicts cardiovascular events in aortic coarctation

Paul Luijendijk1, Huangling Lu2, Frederike B Heynneman3

  • 1Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.

International Journal of Cardiology
|September 11, 2014
PubMed

Insights

Adults who had coarctation of the aorta repair face higher cardiovascular risks. Increased carotid intima-media thickness (CIMT) predicts these events, signaling early atherosclerosis. CIMT is a valuable tool for risk assessment in these patients.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Medical Imaging

Background:

  • Adults post-coarctation repair (CoA) exhibit elevated cardiovascular morbidity and mortality.
  • Carotid intima-media thickness (CIMT) is a validated marker for atherosclerosis and is increased in CoA patients.
  • Early detection of atherosclerosis is crucial for managing cardiovascular risk in CoA survivors.

Purpose of the Study:

  • To determine the predictive value of CIMT for cardiovascular events in adult post-coarctation repair patients.
  • To compare CIMT and atherosclerosis progression in CoA patients versus controls.
  • To assess the clinical utility of CIMT in cardiovascular risk stratification for CoA.

Main Methods:

  • Prospective study of 160 adult CoA patients over a 10.1-year follow-up.
  • Baseline and follow-up assessments included echocardiography, MRI, and CIMT imaging.
  • Cardiovascular events (myocardial infarction, CVA, cardiac death) were systematically registered.

Main Results:

  • An increased baseline CIMT (≥0.8 mm) was a significant predictor of cardiovascular events (HR=15.44, P<0.001).
  • CoA patients showed increased baseline CIMT compared to controls (0.64±0.12 mm vs 0.57±0.07 mm, P=0.005).
  • Signs of atherosclerosis appeared earlier in CoA patients, despite similar CIMT progression rates.

Conclusions:

  • The 10-year cardiovascular event rate in adult CoA patients is 11%.
  • CoA patients with CIMT ≥0.8 mm face a 15-fold higher risk of cardiovascular events.
  • CIMT is a valuable tool for assessing cardiovascular risk in adult patients with a history of coarctation repair.
Abstract

Keywords:
Aortic coarctationAtherosclerosis progressionCardiovascular eventsCarotid intima–media thickness

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